The aims of this prospective cohort study were to monitor childhood blood pressure (BP) and cholesterol and link them to fetal and childhood growth. Of the 215 children recruited after delivery in a rural county of eastern Finland during 1981 and 1982, 180 (83.7%) stayed in the study until the age of seven. The measurements assessed were BP, serum cholesterol and anthropometry. Of the children originally in the highest BP quartile at the age of 6 months, 58% (systolic BP (SBP)) and 68% (diastolic BP (DBP)), respectively, remained in the same quartile until the age of 7 years; 53% (SBP) and 60% (DBP), respectively, remained in the same lowest quartile. Consequently, BP at 6 months correlated strongly with SBP (r=0.69, P < 0.001) and DBP (r=0.75, P < 0.001) at 7 years of age. Birth weight, ponderal index, placental weight and placental to birth weight ratio were not related to BP level during the follow-up. Weight at 1 year of age correlated positively with SBP (r=0.18-0.25, P=0.0008-0.0215) but not with DBP during the follow-up. Weight gain during the first year of life was directly related to subsequent SBP (r=0.11-0.22, P=0.005-0.16). There was an inverse relationship between serum cholesterol at 7 years of age and placental weight (r=-0.16, P=0.048) and placental to birth weight ratio (r=-0.16, P=0.045). The BP level is already determined at 1 year of age and a higher SBP is associated with a higher growth rate during the first year of life.